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Evaluation of the Use of 3D Printed Spinal Models to Educate and Assess Osteopathic Medical Students
Valdés, D. [2]
Zarandy, J. [2]
Sherrington, M. [2]
Cohen, M. [3]
Matechak, J. [1]

Journal: Journal of Osteopathic Medicine Date: 2024/12, 124(12):Pages: A2-A4. doi: Subito , type of study: observational study

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2024-2000/html)

Keywords:

3D [9]
lumbar spine [62]
medical students [659]
models [61]
observational study [228]
osteopathic medicine [2055]
USA [1707]

Abstract:

Context: The understanding of spinal biomechanics, specifically through Fryette’s laws of spinal motion, is a key aspect of the foundation for osteopathic manipulative medicine (OMM) training. With this knowledge, osteopathic physicians may confidently diagnose and treat somatic dysfunctions of the axial skeleton. However, a dynamic and objective teaching tool to educate students on spinal mechanics has not been established [1]. While 3D printing is gaining utility in academia, it is only just beginning to be used within osteopathic educational settings. Currently, only one study employing the use of 3D printing in osteopathic medicine has been published, which involves a 3D printed model to demonstrate inhalation/exhalation rib dysfunctions [2]. Thus, we present the creation of a 3D-printed spinal model of the lumbar spine and its assessment for incorporation into the OMM curriculum. Through its use as an educational tool, the goal is to facilitate student understanding of the complexity of vertebral somatic dysfunction diagnosis, as well as to standardize graded assessments of students. Objective: The objectives of the study were to determine the capacity of osteopathic medical students to successfully diagnose somatic dysfunctions on a 3D-printed spinal model and assess the ability of the model to replicate human spinal mechanics and be used as a tool for learning spinal somatic dysfunctions and objective grading of students’ palpatory skills and knowledge of spinal mechanics in osteopathic medical school. Methods: This study used a 3D-printed prototype box model with five spaces that allowed the magnetic insertion of select 3D-printed vertebrae to represent normal and/or somatic dysfunction in the planes of sidebending and rotation. This study was composed of three phases assessing volunteer first and second-year osteopathic medical students at the Philadelphia College of Osteopathic Medicine Georgia through a single-case experimental design, featuring both an objective quantitative assessment and a subjective qualitative assessment of the 3D model in comparison to live human models. The first phase mimicked the current standard of education, by reviewing the principles of Fryette mechanics as taught within the osteopathic medical school curriculum. During the second phase, participants were asked to palpate the lumbar spine (L1-L5) and make a formal assessment of each vertebrae on both a live human model and a 3D printed model. During the third phase, the students were given the chance to further interact with the 3D models and filled out a survey on their assessment of its value as an educational tool. Results: A total of 90 students participated in the study, with 88 completing all 3 phases. Participants assessed rotation and sidebending of vertebrae L1-L5 on 3D-printed spinal models and live human models, totaling 440 assessments. Results showed 52.73% and 48.41% accuracy for rotation and sidebending assessments, respectively, on live models, compared to 46.59% and 38.18% on 3D models. Chi-square analysis revealed no significant difference in rotational assessments (p=0.069) but a moderate association favoring live models for sidebending (p=0.002, Cramer’s V=0.103). Diagnostic accuracy showed no significant difference (p=0.349).Students rated the 3D models and human models similarly for reliability and objectivity, but favored the 3D models for convenience, non-intimidation, and enjoyment. However, they found human models “preferable.” Students rated 3D models positively for educational use, indicating improvement in palpation skills, diagnostic ability, understanding of Fryette concepts, and confidence, with a preference for using them in various learning contexts. Conclusion: The results of our study showed that in comparing our prototype 3D-printed spinal model with live humans, there is no significant difference in students’ ability to assess the rotational component of somatic dysfunction or their ability to diagnose vertebral segments accurately. However, students performed significantly better in correctly assessing the sidebending portion of somatic dysfunction on live models, indicating the need for future prototypes of the 3D-printed models to focus on augmenting the sidebending component.Students rated the 3D models and human models similarly for reliability and objectivity, but preferred 3D models for being convenient, enjoyable, and less intimidating. However, they found human models preferable overall. Students rated 3D models positively for educational use, indicating improvement in palpation skills, diagnostic ability, understanding of Fryette concepts, and confidence, with a preference for using them in various learning contexts. Hence, while this version of our 3D-printed models needs improvement before it can confidently be incorporated in a standardized practical examination setting, the results do currently favor its use as an educational tool and adjunct. Future versions of our model will focus on improving the overall likeness to a human spine to enhance student palpatory skills and ability to correctly diagnose spinal somatic dysfunctions in patients.

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